M Urrutia-Pereira1, D Solé2, N A Rosario3, H J C Neto3, V Acosta4, C F Almendarez5, M M Avalos6, H Badellino7, F Berroa8, M Álvarez-Castelló9, A J Castillo8, R L Castro-Almarales10, M M De la Cruz8, A M Cepeda11, C Fernandez12, M González-León13, J Lozano-Saenz14, C Sanchez-Silot15, J C Sisul-Alvariza16, M Valentin-Rostan17, R O S Sarni18. 1. Unipampa Federal University, Uruguaiana, Rio Grande do Sul, Brazil. 2. Division of Allergy and Clinical Immunology, Federal University of São Paulo, São Paulo, Brazil. Electronic address: dirceu.sole@unifesp.br. 3. Department of Pediatrics, Federal University of Paraná, Paraná, Brazil. 4. Dr Avelino L. Castelán Pediatric Hospital, Chaco, Argentina. 5. Centro de Asma y Alergia, Tegucigalpa, Honduras. 6. Allergy Service of the Hospital ISSSTE, Veracruz, Mexico. 7. Clínica Regional del Este, Córdoba, Argentina. 8. Centro de Medicina Avanzada Dr. Abel González, Dominican Republic. 9. Hospital Universitario General Calixto García, Cuba. 10. Centro Nacional de Biopreparados, Havana, Cuba. 11. Hospital Universitario Metropolitano, Barranquilla, Colombia. 12. Universidad Nacional Del Este, Asuncion, Paraguay. 13. Centro de Pesquisa: Consultorios del médico de familia, Havana, Cuba. 14. Centro Médico San Angel, Xalapa, Mexico. 15. Hospital Universitario Infantil Sur, Cuba. 16. Clínica de Alergia y Asma, Asuncion, Paraguay. 17. Hospital Pediatrico Pereira Rossell, Montevideo, Uruguay. 18. ABC Foundation School of Medicine, Brazil.
Abstract
BACKGROUND: Atopic dermatitis (AD) has been associated with impairment of sleep. The aim of this study was to evaluate sleep disorders in AD Latin-American children (4-10 years) from nine countries, and in normal controls (C). METHODS: Parents from 454 C and 340 AD children from referral clinics answered the Children Sleep Habits Questionnaire (CSHQ), a one-week retrospective 33 questions survey under seven items (bedtime resistance, sleep duration, sleep anxiety, night awakening, parasomnias, sleep-disordered breathing and daytime sleepiness). Total CSHQ score and items were analysed in both C and AD groups. Spearman's correlation coefficient between SCORAD (Scoring atopic dermatitis), all subscales and total CSHQ were also obtained. RESULTS: C and AD groups were similar regarding age, however, significantly higher values for total CSHQ (62.2±16.1 vs 53.3±12.7, respectively) and items were observed among AD children in comparison to C, and they were higher among those with moderate (54.8%) or severe (4.3%) AD. Except for sleep duration (r=-0.02, p=0.698), there was a significant Spearman's correlation index for bedtime resistance (0.24, p<0.0001), sleep anxiety (0.29, p<0.0001), night awakening (0.36, p<0.0001), parasomnias (0.54, p<0.0001), sleep-disordered breathing (0.42, p<0.0001), daytime sleepiness (0.26, p<0.0001) and total CSHQ (0.46, p<0.0001). AD patients had significantly higher elevated body mass index. CONCLUSION: Latin-American children with AD have sleep disorders despite treatment, and those with moderate to severe forms had marked changes in CSHQ.
BACKGROUND:Atopic dermatitis (AD) has been associated with impairment of sleep. The aim of this study was to evaluate sleep disorders in AD Latin-American children (4-10 years) from nine countries, and in normal controls (C). METHODS: Parents from 454 C and 340 ADchildren from referral clinics answered the Children Sleep Habits Questionnaire (CSHQ), a one-week retrospective 33 questions survey under seven items (bedtime resistance, sleep duration, sleep anxiety, night awakening, parasomnias, sleep-disordered breathing and daytime sleepiness). Total CSHQ score and items were analysed in both C and AD groups. Spearman's correlation coefficient between SCORAD (Scoring atopic dermatitis), all subscales and total CSHQ were also obtained. RESULTS: C and AD groups were similar regarding age, however, significantly higher values for total CSHQ (62.2±16.1 vs 53.3±12.7, respectively) and items were observed among ADchildren in comparison to C, and they were higher among those with moderate (54.8%) or severe (4.3%) AD. Except for sleep duration (r=-0.02, p=0.698), there was a significant Spearman's correlation index for bedtime resistance (0.24, p<0.0001), sleep anxiety (0.29, p<0.0001), night awakening (0.36, p<0.0001), parasomnias (0.54, p<0.0001), sleep-disordered breathing (0.42, p<0.0001), daytime sleepiness (0.26, p<0.0001) and total CSHQ (0.46, p<0.0001). ADpatients had significantly higher elevated body mass index. CONCLUSION: Latin-American children with AD have sleep disorders despite treatment, and those with moderate to severe forms had marked changes in CSHQ.